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Atopic dermatitis: pathogenesis. 特应性皮炎:发病机制。
Seminars in cutaneous medicine and surgery Pub Date : 2017-09-01 DOI: 10.12788/j.sder.2017.036
Emma Guttman-Yassky, Andrea Waldman, Jusleen Ahluwalia, Peck Y Ong, Lawrence F Eichenfield
{"title":"Atopic dermatitis: pathogenesis.","authors":"Emma Guttman-Yassky,&nbsp;Andrea Waldman,&nbsp;Jusleen Ahluwalia,&nbsp;Peck Y Ong,&nbsp;Lawrence F Eichenfield","doi":"10.12788/j.sder.2017.036","DOIUrl":"https://doi.org/10.12788/j.sder.2017.036","url":null,"abstract":"<p><p>Atopic Dermatitis (AD) is a complex inflammatory cutaneous disorder characterized by immune mediated inflammation and epidermal barrier dysfunction. Arising from a complex interplay between environmental and genetic factors, the definitive etiology of AD is perplexing and controversial. Advances in molecular medicine are radically transforming our understanding of AD pathogenesis. Increasing knowledge on the pathogenesis of AD results in novel therapeutic targets and pathways. This article details the pathogenesis section of the Curriculum United for Better Eczema Care (CUBE-C), facilitating primary care and sub-specialist education on the scientific advances driving recent AD therapeutic innovations.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 3","pages":"100-103"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35343568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 57
Atopic dermatitis: emerging therapies. 特应性皮炎:新兴疗法。
Seminars in cutaneous medicine and surgery Pub Date : 2017-09-01 DOI: 10.12788/j.sder.2017.0137
Eric Simpson, Jeremy Udkoff, Jenna Borok, Wynnis Tom, Lisa Beck, Lawrence F Eichenfield
{"title":"Atopic dermatitis: emerging therapies.","authors":"Eric Simpson,&nbsp;Jeremy Udkoff,&nbsp;Jenna Borok,&nbsp;Wynnis Tom,&nbsp;Lisa Beck,&nbsp;Lawrence F Eichenfield","doi":"10.12788/j.sder.2017.0137","DOIUrl":"https://doi.org/10.12788/j.sder.2017.0137","url":null,"abstract":"<p><p>Crisaborole and dupilumab represent the first 2 Food and Drug Administration (FDA)-approved therapies for atopic dermatitis (AD) in more than 15 years, and there are many promising drugs currently in development. This new wave of therapeutics capitalizes on the large body of work clarifying the pathogenesis of AD over the last several decades. In particular, type 2 cytokine-driven inflammation and skin barrier dysfunction are key processes underlying AD pathogenesis.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 3","pages":"124-130"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35503369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Curriculum United for Better Eczema Care: why, how, and what? 课程联合为更好的湿疹护理:为什么，如何，和什么?
Seminars in cutaneous medicine and surgery Pub Date : 2017-09-01 DOI: 10.12788/j.sder.2017.033
Lawrence F Eichenfield, Jusleen Ahluwalia, Dawn Marie Davis, David M Fleischer, Andrea Waldman, Jonathan Spergel
{"title":"Curriculum United for Better Eczema Care: why, how, and what?","authors":"Lawrence F Eichenfield,&nbsp;Jusleen Ahluwalia,&nbsp;Dawn Marie Davis,&nbsp;David M Fleischer,&nbsp;Andrea Waldman,&nbsp;Jonathan Spergel","doi":"10.12788/j.sder.2017.033","DOIUrl":"https://doi.org/10.12788/j.sder.2017.033","url":null,"abstract":"<p><p>While various medical specialties treat eczema patients, care for these patients is largely fragmented and disorganized. Moreover, standardized treatment protocols that incorporate upcoming eczema therapies and emerging guidelines have yet to be established. Thus, there is both a need and an opportunity to equip clinicians to succeed in this novel and changing era of eczema care. The National Eczema Association's (NEA) strategic plan-developed through extensive discussions with patients who have atopic dermatitis and their caregivers, industry, and providers representing different specialties-called for the creation of an interdisciplinary coalition to steer this initiative. The Coalition United for Better Eczema Care (CUBE-C) is a network of cross-specialty leaders working to help construct an educational curriculum based on standards of effective treatment and disease management.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 3","pages":"93-94"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35343566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atopic dermatitis: addressing allergy, infection, itch and complementary therapies. 特应性皮炎:解决过敏，感染，瘙痒和补充疗法。
Seminars in cutaneous medicine and surgery Pub Date : 2017-09-01 DOI: 10.12788/j.sder.2017.038
Jusleen Ahluwalia, Dawn Marie Davis, Sharon Jacob, Andrea Waldman, Peter Y Ong, Stuart Cohen, Adam Friedman, Peter Lio, Nathan Jetter, Jeffrey Bienstock, Jennifer LeBovidge, Jonathan Spergel, Luz Fonacier
{"title":"Atopic dermatitis: addressing allergy, infection, itch and complementary therapies.","authors":"Jusleen Ahluwalia,&nbsp;Dawn Marie Davis,&nbsp;Sharon Jacob,&nbsp;Andrea Waldman,&nbsp;Peter Y Ong,&nbsp;Stuart Cohen,&nbsp;Adam Friedman,&nbsp;Peter Lio,&nbsp;Nathan Jetter,&nbsp;Jeffrey Bienstock,&nbsp;Jennifer LeBovidge,&nbsp;Jonathan Spergel,&nbsp;Luz Fonacier","doi":"10.12788/j.sder.2017.038","DOIUrl":"https://doi.org/10.12788/j.sder.2017.038","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a complex condition that results from the dynamic interplay between genetic predisposition, skin barrier defects, environmental factors, and a dysfunctional immune system. As a result, AD can be complicated by irritant and allergic contact dermatitis and imbalances in the skin microbiome, which can subsequently exacerbate the severity and complicate the course of preexisting atopic disease. Itch is an important symptom of AD, as it plays a large role in the quality of life of patients and their families. Since AD is a chronic, inflammatory disease that recrudesces throughout life, many have utilized alternative and/or complementary therapies, as monotherapy or in conjunction with conventional therapies, as a form of management.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 3","pages":"112-117"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35343569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Topical management and wound care approaches for hidradenitis suppurativa. 化脓性汗腺炎的局部处理和伤口护理方法。
Seminars in cutaneous medicine and surgery Pub Date : 2017-06-01 DOI: 10.12788/j.sder.2017.020
Camila Antia, Afsaneh Alavi, Ali Alikhan
{"title":"Topical management and wound care approaches for hidradenitis suppurativa.","authors":"Camila Antia,&nbsp;Afsaneh Alavi,&nbsp;Ali Alikhan","doi":"10.12788/j.sder.2017.020","DOIUrl":"https://doi.org/10.12788/j.sder.2017.020","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic inflammatory disease that affects the follicular unit in apocrine glandbearing skin, resulting in deep-seated nodules, sinus tracts, abscesses, and ultimately scarring. HS is a highly distressing condition, and has one of the highest impacts on quality of life compared to other dermatologic diseases. Various topical therapies have been described that may be used alone or in conjunction with systemic or physical modalities for HS. Additionally, proper wound care is essential to the successful management of HS, particularly given the suppurative nature of the disease. However, limited evidence exists regarding the optimal regimen for topical therapy and wound care. On the basis of existing literature, we provide a comprehensive review of topical management and wound care.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 2","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35022695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
A retrospective review of light- and laser-based management of hidradenitis suppurativa. 光和激光治疗化脓性汗腺炎的回顾性研究。
Seminars in cutaneous medicine and surgery Pub Date : 2017-06-01 DOI: 10.12788/j.sder.2017.023
Melissa A Levoska, Cynthia L Nicholson, Iltefat H Hamzavi
{"title":"A retrospective review of light- and laser-based management of hidradenitis suppurativa.","authors":"Melissa A Levoska,&nbsp;Cynthia L Nicholson,&nbsp;Iltefat H Hamzavi","doi":"10.12788/j.sder.2017.023","DOIUrl":"https://doi.org/10.12788/j.sder.2017.023","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic skin disease that is difficult to manage and often refractory to medical management. Light and laser therapies have been utilized in the field of dermatology to treat a variety of skin conditions, but more recently were studied in the management of HS. Usually performed as outpatient procedures with a low risk of complications, they offer several advantages to traditional cold knife surgical procedures. We reviewed the various light- and laser-based treatments studied in HS and compared their efficacy. Outcome measures were not standardized, which made comparison difficult. Studies performed were few in number and often limited by small patient samples. Larger, randomized controlled trials that compare these treatment modalities to medical and surgical management are needed. Despite their limitations, light- and laser-based therapies are promising treatment options for patients with refractory HS.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 2","pages":"67-74"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35022697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Complications of hidradenitis suppurativa. 化脓性汗腺炎的并发症。
Seminars in cutaneous medicine and surgery Pub Date : 2017-06-01 DOI: 10.12788/j.sder.2017.022
Joyce T Yuan, Haley B Naik
{"title":"Complications of hidradenitis suppurativa.","authors":"Joyce T Yuan,&nbsp;Haley B Naik","doi":"10.12788/j.sder.2017.022","DOIUrl":"https://doi.org/10.12788/j.sder.2017.022","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent painful nodules and abscesses involving intertriginous areas. Repeated episodes of profound inflammation in HS can lead to a number of complications, causing significant morbidity and decreasing quality of life. Complications of HS may affect the skin alone or may have systemic impact. Cutaneous complications of HS include sinus tracts, fistulae, scarring and contractures, squamous cell carcinoma, and lymphedema. Systemic complications of HS include chronic pain, systemic amyloidosis, and possibly anemia. Preventing disease complications by controlling primary disease is a key component of HS management. Clinicians should be prepared to recognize complications early, as prompt management is necessary to minimize negative impacts.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 2","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35022612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Pathophysiology of hidradenitis suppurativa. 化脓性汗腺炎的病理生理学。
Seminars in cutaneous medicine and surgery Pub Date : 2017-06-01 DOI: 10.12788/j.sder.2017.017
Lauren K Hoffman, Mondana H Ghias, Michelle A Lowes
{"title":"Pathophysiology of hidradenitis suppurativa.","authors":"Lauren K Hoffman,&nbsp;Mondana H Ghias,&nbsp;Michelle A Lowes","doi":"10.12788/j.sder.2017.017","DOIUrl":"https://doi.org/10.12788/j.sder.2017.017","url":null,"abstract":"<p><p>The pathophysiology of hidradenitis suppurativa (HS) is not well understood. Some of our knowledge comes from clinical and epidemiological observations, along with studies of the histopathology and immunohistochemistry of affected skin. More recently, cutaneous molecular studies and transcriptomic analyses have provided additional information regarding inflammatory processes. The chronic cutaneous inflammation, systemic symptoms, and associated comorbidities suggest that HS should be classified as an immune-mediated disease, rather than a primary infectious disease. As such, a proposed integrated disease pathway is presented. At a fundamental level, there appears to be a primary abnormality in the pilosebaceous-apocrine unit, which leads to follicular occlusion, perifollicular cyst development that traps commensal microbes, and rupture into the dermis. This can trigger an exaggerated response of the cutaneous innate immune system. Initially this is an acute event, but ongoing intermittent disease activity can lead to recurrent inflammatory nodules and dermal tunnels. Once underway, the cutaneous inflammation is very difficult to turn off, leading to suppurative inflammation in whole anatomic regions. As the disease progresses, we propose that there is recruitment of the systemic immune system perpetuating the chronic cutaneous inflammatory process. There remains much to be done to understand the pathogenesis and immune signature of this challenging disease.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 2","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35022693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 91
Major gaps in understanding and treatment of hidradenitis suppurativa. 认识和治疗化脓性汗腺炎的主要差距。
Seminars in cutaneous medicine and surgery Pub Date : 2017-06-01 DOI: 10.12788/j.sder.2017.024
Lauren K Hoffman, Mondana H Ghias, Amit Garg, Iltefat H Hamzavi, Afsaneh Alavi, Michelle A Lowes
{"title":"Major gaps in understanding and treatment of hidradenitis suppurativa.","authors":"Lauren K Hoffman,&nbsp;Mondana H Ghias,&nbsp;Amit Garg,&nbsp;Iltefat H Hamzavi,&nbsp;Afsaneh Alavi,&nbsp;Michelle A Lowes","doi":"10.12788/j.sder.2017.024","DOIUrl":"https://doi.org/10.12788/j.sder.2017.024","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a complex dermatological disease characterized by recurrent painful nodules and suppuration in areas such as the axilla and groin. The disease is poorly understood and treatment is not satisfactory. In October 2016, the Canadian and United States Hidradenitis Suppurativa Foundations organized the inaugural Symposium on Hidradenitis Suppurativa Advances (SHSA) in Toronto, Canada. This meeting brought together experts from Canada, the United States, and Europe to discuss the latest advances in HS. After this important event, we considered that it would be helpful to outline current HS knowledge and to identify important gaps in treatment and research in order to move forward more efficiently. This paper briefly summarizes current knowledge in key areas including epidemiology, clinical presentation and morphological classification, natural history and prognosis, genotype-phenotype correlations, clinico-pathological correlation, pathogenesis, optimal treatment and outcome measures. General and initial suggestions for addressing these gaps are presented.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 2","pages":"86-92"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35022613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 23
Medical management of hidradenitis suppurativa. 化脓性汗腺炎的医学处理。
Seminars in cutaneous medicine and surgery Pub Date : 2017-06-01 DOI: 10.12788/j.sder.2017.021
Lauren Av Orenstein, Robert G Micheletti
{"title":"Medical management of hidradenitis suppurativa.","authors":"Lauren Av Orenstein,&nbsp;Robert G Micheletti","doi":"10.12788/j.sder.2017.021","DOIUrl":"https://doi.org/10.12788/j.sder.2017.021","url":null,"abstract":"<p><p>Hidradenitis suppurativa is a chronic inflammatory disease of the folliculo-infundibular unit for which no individual treatment is uniformly effective. A wide array of therapies has been reported successful in the treatment of hidradenitis, although few high-quality clinical trials have been conducted. Comparing the effectiveness of different therapies has proven challenging due to heterogeneity and limited validation of outcome measures. We performed a systematic review of clinical trials of medical treatments for hidradenitis, yielding 8 articles reporting on 9 trials of antibiotic, hormonal, and biologic therapies. In addition, we discuss existing observational data on commonly used therapeutic regimens, as well as the outcome measures driving clinical research in hidradenitis suppurativa.</p>","PeriodicalId":21714,"journal":{"name":"Seminars in cutaneous medicine and surgery","volume":"36 2","pages":"62-66"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35022696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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